Exploring the relationship between severity of patient illness and in room primary care nursing time in a medical intensive care unit

Abstract

This study explores a connection between sequential organ failure assessment (SOFA) of patients in a medical intensive care unit (ICU) and primary care nursing time. Although ICU nurses have many responsibilities that impact patient outcomes, little is known about how the severity of a patient's illness influences the time and activities that nurses dedicate to primary care within a medical ICU. Data collection was set for February to April 2020, as suspended on March 11 due to COVID-19. It resumed on July 6, 2020, after clinical research activities were reinstated. We collected data for a time-motion study. We combined the manual observation data with the real-time location data of a Near Field Electromagnetic Ranging (NFER) system to analyze how time is structured in primary care. Our goal was to investigate the impact of a patient's illness severity on how time is allocated in intensive care nursing. Overall, there was no significant difference between February and July in terms of time spent on primary care and peer support activities. However, for specific primary-care tasks, ICU nurses spent less time on patient assessment, patient care, and medication tasks compared to February, significantly more time on patient transport in July. In the February data, we found a significant correlation between the SOFA score and the time devoted to primary care, indicating a meaningful association between patient illness severity and the allocation of nursing time. However, in the July data, no correlation was found between the SOFA score and the time spent on primary care. These findings improve our understanding of the challenges that nurses experience in medical ICU units, emphasizing the necessary adjustments to enhance nursing care.

Keywords: Intensive care unit; Severity of illness; Time-motion study.